How to Read CMS Ratings and Inspections
Nursing home star ratings
CMS gives each nursing home an overall rating of 1 to 5 stars built from three parts: health inspections (the results of on-site surveys and complaint investigations over roughly three years), staffing (nurse and aide hours per resident per day, adjusted for how sick residents are, plus staff turnover) and quality measures (outcomes such as falls, pressure ulcers, hospitalizations and antipsychotic use). Health inspections carry the most weight.
Inspection severity letters
| Letter | How widespread | How serious |
|---|---|---|
| A | Isolated | No actual harm, potential for minimal harm |
| B | Pattern | No actual harm, potential for minimal harm |
| C | Widespread | No actual harm, potential for minimal harm |
| D | Isolated | No actual harm, potential for more than minimal harm |
| E | Pattern | No actual harm, potential for more than minimal harm |
| F | Widespread | No actual harm, potential for more than minimal harm |
| G | Isolated | Actual harm |
| H | Pattern | Actual harm |
| I | Widespread | Actual harm |
| J | Isolated | Immediate jeopardy to resident health or safety |
| K | Pattern | Immediate jeopardy to resident health or safety |
| L | Widespread | Immediate jeopardy to resident health or safety |
Letters G through L mean residents were actually harmed or put in immediate jeopardy. A single J, K or L citation is a serious finding worth asking the facility about.
Special Focus Facilities and the abuse icon
CMS places a small number of nursing homes with a persistent record of serious problems in the Special Focus Facility program, with more frequent inspections. The abuse icon marks facilities cited for abuse, neglect or exploitation recently.
Home health, hospice, hospitals and dialysis
Home health agencies get a quality-of-care star rating and a patient-survey star rating. Hospitals receive an overall star rating from mortality, safety, readmission, patient experience and timeliness measures. Dialysis facilities receive a five-star rating from patient outcomes. Hospice providers report quality measures and the Hospice Care Index (0–10).
Source: CMS Care Compare technical documentation and the CMS Provider Data Catalog.